Healthcare Provider Details

I. General information

NPI: 1780262576
Provider Name (Legal Business Name): GREG MARTINS OJI, MD. INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2021
Last Update Date: 08/07/2024
Certification Date: 08/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

931 BUENA VISTA ST STE 302
DUARTE CA
91010-1714
US

IV. Provider business mailing address

931 BUENA VISTA ST STE 302
DUARTE CA
91010-1714
US

V. Phone/Fax

Practice location:
  • Phone: 201-234-9238
  • Fax:
Mailing address:
  • Phone: 201-234-9238
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: GREG MARTINS OJI
Title or Position: OWNER
Credential: MD
Phone: 201-234-9238